Category Archives: Healthcare

Small World, Small Minds

Note: I started my volunteer gig on Monday.  My very first day, I sort of got in trouble for reporting a problem that the “powers that be” subsequently told me wasn’t a problem.  

So, I am going to avoid situations where the “not-a-problem” comes up, in order to stay clean if the shit hits the fan.  Because I take these kinds of “not-a-problem” things really seriously and will not risk my reputation – such as it is – for social reasons and to “get along”.  

Yesterday I atoned for it by repackaging 160 bags of candy for resale.  And was chatty and pretended to like being bossed around by 80 year old women who get sarcastic and mean if things are not done “just so”.

I marveled at the fact that they were able to sit and stand for much longer periods of time than I was. Physically, these first days were hard on me.  The walk to the bus stop to go home is uphill and difficult.  I fell asleep both days during the hour-long trip on the bus going home.

Thankfully, I have today off.

Today’s blog post is about something that happened last week on the van…

I recently wrote a blog post called “Free Garbage is Still…Garbage”, in which I mentioned that many people do not understand how poor folk live in America.  I was writing mainly about people who have never “been there”, people who never think about unpleasant things like hunger and poverty, or people who basically think that being poor is self-inflicted.

Well, I ran into another representative of a group of people who like to complain about people who live on disability – that small but vocal percentage of people who are on disability themselves, but who deserve it!  Because they’re really sick!  They really can’t work!

But those “other” lazy bums, they can!  It’s not right!

I was riding the senior van to a facility, going to my volunteer gig orientation.  A very obese man sat in a wheelchair behind me and started the conversation with, “I used to be in a workfare program, and they were supposed to hire me at the job I worked after 2 years, but after 4 years I hadn’t been hired so I demanded that they hire me!”

“Uh oh,” thought I, “a real charmer.”

“Of course,” he continued, “they said why should they hire me when they can get welfare to pay me?”

By now I am rolling my eyes.  Because you just know that no one said any such thing.

Aside #1: It may have actually been true, but I don’t think they would have told him that to his face – that kind of stuff results in lawsuits.

So he was embellishing somewhat, ok.  We all do it sometimes.

“But then I got arthritis,” he said, “and I couldn’t work.”

He paused, then angrily stated, “It doesn’t matter anyway, because you have to know someone or be related to someone in order to get a job here.  I even went to go see the guy I used to caddy for, and told him I needed a job, but he wouldn’t hire me!  I told him he could either hire me, or pay my way through his social security payments!”

Yeah, because that will surely convince someone to give you a job.

Aside #2: Again, there is some truth to the idea that, in provincial Altoona and in the even more provincial surrounding small towns, you have to know someone/be related to someone to get a job. Mostly because everyone around here is related to someone, or knows someone who is connected to them in some way, who is in a position to hire them/give them a reference (or talk unkindly about them being a troublemaker, in my case).

He was on a roll now. “But you know what makes me so mad?  All these bums on social security who say they can’t work because they have drug and alcohol problems.  They just have to set their minds to not using or drinking, and go back to work!  They’re just lazy!”

Ding ding ding – hot button pushed, right there.

“Now wait a minute,” I objected, “people who are addicted to drugs or alcohol do have a hard time holding a job.  They have a problem that needs to be addressed.”

“Yeah, but it’s all in their heads!  They could work if they wanted to!” he argued.

I sighed.  “You would agree that these substances affect your brain, right?”

“Yeah,” he replied.

“And you would agree that your brain is the thing you think with?  So these substances cause an impairment in the way people think,” I tried to explain.

“Exactly!” he beamed.  “That’s why they can just set their minds to not doing it anymore, and go to work!”

I gave up.  He clearly wasn’t going to get it.  I tried another tactic.

“Welfare and social security fraud is only at about 2%, that’s less than just about at any other government program.  So it’s not that many people,” I stated.

“I know TONS of guys who just sit around all day.  Why, just look at THEM!”  He pointed to 3 guys crossing the street.  They were all about 30, I guess, and were not white.

“Do you know them?” I asked.

“Well, no, but they should be at work!” he exclaimed.

Ok, this guy was just not going to get it.  He has decided that any minority person who is ambulatory and “doesn’t look sick” is just scamming the system.  People like him never seem to change.

So I dropped the subject and stared out the window at the scenery, annoyed.

With all the problems this guy has – health being the major one – he is worried about people he thinks might be taking advantage of the opulent living we on social security disability have?

But he himself is on social security disability.  Surely he knows this ain’t no “high-on-the-hog” living.

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Free Garbage is Still…Garbage.

I remember talking to someone a few years back, about the local food pantry here in our little town (which is also the county seat, so it’s not exactly unsophisticated).   I had good and bad comments about the food pantry, but the whole experience left me wondering about how that and the healthcare system are somewhat intertwined.

First, the positive – the food pantry here delivers.  That’s really awesome and helpful, especially since the pantry is on the outskirts of town, where buses don’t go.  So, for those of us without a car, that’s a really nice thing for them to do.

The people who deliver the food are very nice, and when you try to thank them they say, “Don’t thank me, thank God,” which I take as the modest statement it is.  They are using their own cars to bring food to my apartment, and I think it’s really nice of them to do that.

Aside #1: Contrary to some misconceptions, I do not argue with every Christian who expresses thoughts about Jesus or saints or whatever deity they choose.  I fully support their right to believe as they wish.  My complaints only come into play when they try to force others to believe as they do, or force others to participate in their worship, or make judgments about neo-Pagans/non-believers being evil and so on.

The bad part about the food pantry here?  It’s nothing but unhealthy food.

Day-old baked goods like cake and cookies (which are, of course, yummy), white bread, canned vegetables with high salt content and lined with BPA, juice “drinks” (basically the ones with juice flavoring and sugar), hot dogs, beans (in cans, not dried beans), and tomato soup (very high in sodium).  And usually ramen – lots and lots of ramen.

Aside #2: Beans are the only things that are remotely healthy on this list, but they always seem to come in extremely large cans, are processed, and in general are not all that good for you. I don’t know why they don’t give out dried beans, as these are much cheaper, keep longer, and are easy to make – and better for you.

I received this a couple of times when my son was living here with me, as we had a very hard time making ends meet on just my food stamps.  Thankfully, he got some assistance and we didn’t have to call these folks again.

Thankfully, too, he got a job down south years ago and never has to live like this again.

I mentioned the unhealthiness of this stuff to someone, who then turned to me and said, “At least it’s free.”

Garbage out of dumpsters is free, too, but it’s still garbage.

Since the person I was talking to was somewhat conservative, I asked him what he thought the extra cost to the healthcare system is, due to people eating unhealthy food for prolonged periods of time.

Aside #3: Heart disease, hypertension, obesity, diabetes, and other diseases can sometimes be prevented, or often can be ameliorated, by eating decent food.  That means little or no sugar, fresh vegetables (or at least frozen ones), fruit, fiber (like beans), and grains.

He thought for a minute and said, “I think we should pass laws so people can only buy certain things with food stamps.   That way, they would have to eat healthy food.”

Sigh.  I should have known – conservatives are not known for their generosity.  Or for their understanding of how po’ folk live.  Or for supporting other peoples’ self-determination.

Should we also pass laws telling private charities what they can and cannot give out at the food pantry, too?

Of course not.  The answer lies in education.  Education for everyone.

The people running the food pantries need to be educated so they can in turn educate their donors on what to give.  I think most people would love to know that what they give could make a huge difference in someone’s health.  And I think if they knew what to buy, and were shown how cheaply they can buy it, it would be a win/win kind of thing.

The people receiving food from the pantry could use some education, too (no, not all of them, and it’s not just the poor – most Americans don’t eat healthily).  I don’t mean about the food groups and so on, I mean education regarding how to prepare meals from scratch.

Many people do not know how to cook from scratch, poor or not.  But it’s not hard.  Cooking rice and beans from scratch takes time, mostly, not brains.  You can cook a whole bunch on the weekend and freeze it all, if need be.

Some poor people do actually work (for Walmart, too, but that’s another blog post).  They have families.  They might not have the energy or time to cook from scratch, unless they are given the tools by which to do so.

By “tools”, I mean…cookbooks.  Heck, you can have volunteers cut recipes from magazines, punch holes in them, and put them in binders for very little effort or money.  Or you could get people to donate cookbooks (though that’s probably a bit harder – most people’s cookbooks are not basic like Adele Davis’ “Let’s Eat Right to Keep Fit”).

Aside #4: I always thought Adele Davis wrote “Recipes for a Small Planet”, but that was Frances Moore Lappe.   Adele Davis, by the way, was the person who coined the phrase “You are what you eat.”

You could even – gasp – ask businesses to donate crockpots.  They are not very expensive, and you can dump all the ingredients into one, set it, go to work, and have dinner by the time you get home.

You could get people to donate freezer-ware, and include instructions.  You can get containers to freeze things in at Dollar Tree – and all their stuff is BPA-free, I asked.  $1 for a set of 3 or more – cheaper if you buy by the case.

All of these things still add up to a lot less than hospitalizing someone who’s had a heart attack or other possibly preventable illness.  Which would keep healthcare costs down – that wouldn’t satisfy Libertarians or right-wingers, who both want to see po’ folk not get any healthcare at all – but for most normal people, this would be a good thing.

And why should we think about how we can help the poor eat more healthy food, and save on Medicare/Medicaid costs?  Because it’s the decent thing to do, and because it saves money in the long run (i.e., your tax dollars – and theirs, too, by the way, since many of them work).

But…what about people who work and don’t qualify for food stamps or government health insurance?

To them I say, “Be quiet, and be grateful that your life isn’t so horrible that you have to sit in someone’s office for an hour and explain to them why you don’t have enough food to eat each month.”

Aside #5: The intake process at most food pantries is pretty hard on one’s pride.  They ask you how you got to where you are, and that’s a fairly painful question to answer.  Not even welfare workers ask such nosy questions, or look at you like you’re trying to put one over on them.

To them I also say, “You own a car and a house, have a retirement plan, savings account, and other things that poor people will probably never have.  We would all trade our food stamps and Medicare/Medicaid to have the income you have to afford all those things.”

We’d trade it all just to be able to work at a decent job.  To just have a shot at a life out of poverty.  Most of us aren’t lazy – if people who thought that had to live for a month as we do, where everything takes twice as long to do, or in some cases isn’t even doable, I think they would understand the amount of effort it takes just to survive.

Reiki Don’t Lose That Number

Oh boy, just when I thought things could not get any stranger…

I went to the pain management clinic yesterday, with the intent of discussing tapering off meds, because frankly I am tired of having to schedule my life around my prescriptions (especially since I had to decline a trip to Memphis last Christmas, due to the clinic not understanding how to handle things).

I want to try, because I’m pretty sure my back isn’t getting better – I mean, disks don’t regenerate, unless you’re Dr. Who – and unless and until the DEA stops being so stupid and people are able once again to get meds from chain pharmacies while they are on vacation, I don’t want to be chained to my medication.

This would not be a problem if Walgreen’s, Rite Aid, CVS, and so on would just refill out-of-state prescriptions.  But instead of figuring out a way to do this, and putting practices into place that can prevent fake scripts and so on, they are just cracking down and treating everyone like drug addicts.

As I have written previously, even the DEA misinterprets their own data, which indicate that this “most heroin addicts started on pain medication” idea isn’t true (or is at least suspect, considering it is based on interviewing addicts).

What I mean by this is, when one does admissions interviews for rehab, the question is asked, “How did you become addicted?”

Most people will not state that they became addicted because their family members and friends already do heroin and they felt pressured to try it (surprisingly common in PA, to have entire families addicted).

Most people will not state that they thought heroin would be a decent escape from boredom, or something to do at a party.

No, what most people state is that they had pain, became addicted to pain medication, got cut off by the doctor, and then switched to heroin.

Because they are ashamed, or they don’t want to appear “weak”, or any number of reasons mostly related to saving face.

Yes, even in a rehab setting, there is still this fear of being stigmatized – and, as many of you know, this isn’t an irrational fear.  I have written about the contempt with which many counselors hold their clients/patients.

So, ok…that is my take on why the data are so skewed, and why everyone is freaking out over “pill mills”, opiate addiction, and pain management.

But I digress, sort of.

I went to the pain clinic yesterday, and the first thing I noticed was that there were very few cars in the parking lot.  And very few patients in the waiting room.

And new staff.

As I was signing the monthly “yes-you-can-drug-test-me” form, I noticed at the top that the physician’s assistant in charge was a name familiar to me – he ran an urgent care clinic years ago, and I was a patient of his.

Now, don’t get me wrong, I like this guy.  He’s personable, he’s smart, and likeable.

But he’s a walking advertisement for the Skeptical Enquirer, under the heading of “quack cures and woo-woo science”.  He is someone I would never have thought I would see dispensing pain medication in a clinic.

This guy wears many hats – he’s a Reiki master, a hypnotherapist, and a proponent of “energy healing at a distance”.

I said to him, “Hey, I know you!  You wrote the letter to the unemployment people when I got fired, telling them that I really did have a bad back and that the methadone clinic doctor had brought me in that day.”

Aside #1: The excuse for firing me was that I hadn’t called in to say I was being treated for a disk problem that occured WHEN I WAS AT WORK.  They got me on a technicality, stating that sending the clinic doctor back to pass the word that I wasn’t coming in the next day “wasn’t proper procedure”, and that they had had NO idea where I was.)

I had a hearing with the unemployment people, and my former supervisor lied stated that she had tried to call me numerous times but I wasn’t answering.  I had phone records to disprove this but the guy in charge of the hearing wouldn’t look at them.

I asked him what he had been doing, and what he was doing working in a pain management clinic?

Aside #2: I kinda knew what he was doing, as he’s all over the internet giving lectures on podcasts and at UFO/Paranormal conferences and such, but I wanted to hear about what brought him to this clinic.

He stated he had been living in New Mexico for 3 years.

Of course, probably Taos or some other new age community.

He didn’t say what brought him back here, but he did say that if anyone had told him years ago he would end up working in a pain management clinic, he wouldn’t have believed it.

I agree.  I was rather gobsmacked myself at seeing him there.

I told him I was thinking of tapering off, due to the whole vacation thing.

His suggestion?  “Just don’t take any more.  Detox and get it over with.”

What??

I mean, the guy used to work as a consultant to the rehab company I worked for (which actually gets him a lot of points with me, as he did stick up for me at my hearing).

But he ought to know that one does not just stop taking 60 mg of morphine, cold-turkey.  Yet that was his advice to me, and he added that tapering off is a “form of torture”.

What??

Hey, I don’t even go off antidepressants without tapering.  I don’t need my blood pressure skyrocketing like that, and whether it’s “withdrawal” or “discontinuation syndrome” (withdrawal off “nice” drugs like antidepressants), it’s damn unpleasant.

But he was nice enough to let me decide how to do it, so I went with tapering.

Um…his idea of tapering is cutting the dose in half, right away, and adding a stronger shorter duration opiate like oxycodone “for break-through pain”.

That’s not my idea of tapering but I figured I would give it a shot.

The Stigma of Mental Illness Extends to Healthcare Providers, Too

I am going to write about something that very few therapists discuss – the common myth that therapists “have their shit together”.

And the reality that they don’t.

There’s a reason why you won’t find support groups titled “Therapists Anonymous”, “Bipolar/Depression Support Group for Therapists”, or “Help! My Significant Other is a Therapist!” and so on.

It’s simple, really, as oft-quoted by people who work in the mental health community, “We are supposed to always have our shit together.”

“Supposed to”.  Not, “actually have”. I can count on one hand the number of therapists I have met who are not suffering from some form of mental illness or substance abuse themselves.

It’s (maybe) surprisingly common.

The number one malady I have observed?  Substance abuse. Particularly of benzodiazepines (i.e., Valium, Xanax) and alcohol.

The number two problem? Mood disorders (major depressive, bipolar).

And a close third?  Personality disorders.

This last is truly alarming, because personality disorders are hard to spot and almost impossible to treat – for one thing, people so afflicted quite often do not think they have a problem.

Aside #1: There are 10 types of personality disorders, according to the DSM V (psychiatric diagnostic manual) – paranoid, schizotypal, schizoid, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive. 

Mind you, I want to make it clear that this is based on my observations.  So this is my subjective opinion, nothing more.

The substance abuse issue usually will trip a therapist up in the end, because he or she will often violate boundaries with patients (especially if he or she is a drug and alcohol therapist), act inappropriately (as in, being obviously impaired at work), or get into trouble with the law (DUI, for example).

Although it’s not good for addicted therapists to be treating anyone, for anything, it is at least somewhat self-correcting before too much damage can be done.

The mood disorder problem is the most tragic – for the therapist, anyway – because since a therapist is often unable or afraid to get help, he or she can needlessly suffer for years without anyone knowing.  It’s tragic because it doesn’t need to be that way, but it is that way because there’s no quicker way to get fired than to admit that you have a mental illness.

So no one admits it.

Hiding one’s mental illness is critical.

In other words, the people who are supposed to be so tolerant, so understanding of people afflicted with mental illness are they themselves some of the most judgmental hypocrites around.

The same people who will tell a patient, “Depression is the common cold of mental illness” (6.9% of the American population – and that’s just those adults who are diagnosed – according to the NIMH) in order to reassure the patient that he/she is not some freak of nature, are the same ones who will go to a colleague’s supervisor under the guise of “helping” and relate that so-and-so is on antidepressants that “don’t seem to be helping”.

Aside #2: I have seen it happen to others.  I have had supervisors ask for my clinical opinion of colleagues, and I have refused to give it.  I have heard colleagues complain about other “crazy” therapists, therapists who were good at their jobs and were just too open about having a mental illness – thereby “tarnishing” that “got your shit together” reputation.

It’s tantamount to a doctor getting fired because he/she caught the flu, broke a leg, or suffered from a chronic condition like migraines.  Doesn’t make sense when you look at it that way, does it?

But this is also a good segue into the third mental health problem amongst therapists that I have observed – personality disorders.  And those people are truly dangerous, to patients and staff alike.

Manipulative, self-centered, and fond of drama, a therapist with a personality problem delights in treating very sick patients because he or she – and there’s no polite way of saying this – enjoys seeing people suffer.  And, in fact, I have seen and heard therapists like this make fun of patients in treatment team meetings, display a horrifying lack of empathy, and basically treat the patient as a form of entertainment rather than someone with whom to conduct therapy.

A therapist like this will also cause disruption between staff members, just to sit back and enjoy watching the chaos.  This behavior is evident to staff when patients do it – in fact, the term is called “staff splitting” – but seldom recognized in another staff member until it’s too late (when someone usually gets fired, and it’s not the “sick” therapist).

Aside #3:  I have also seen this behavior in nurses and hospital administrators.  I don’t know if healthcare facilities/professions attract this kind of person, or if I have just had more experience recognizing it.  But I have seen situations where a nurse will go after another, “more popular” (with patients and staff) nurse and get her fired before she knew what hit her.

Ready…Steady…Work!!

I have been thinking a lot about work lately. Because I want to go back.

I want to pay rent and bills, and have money left over to save for things like a car, a passport, and travel – particularly back to my beloved Belfast (which I still can’t see pics of without crying).

I want to be able to go shopping for food and not have to constantly add up prices, and reluctantly put things back.  I cannot even recall what that’s like, for the brief times I wasn’t poor.  I do recall it felt good, though.

I am not one of those people who, even when they make a decent living, pinches every penny and eats crappy food to save money.  I find them really annoying, those “cheap bastards”.

Anyway, I got to thinking, as I was reading websites yesterday.  Since I subscribe to a lot of healthcare blogs, news sites, and so on, I read a lot of stories about people who either are in therapy, or conduct therapy as trained and educated professionals, or “conduct therapy” as laypeople who think “I can do that, I don’t need education”.

I have softened my stance a bit on this last group.  It used to annoy me to no end when people would ask, rhetorically, “Why do I have to jump through a bunch of hoops to get a degree and get licensed, when doing therapy is so easy?  All my friends come to me for help, and they tell me I’m better than any counselor they’ve ever paid to see.”

I used to think, “You arrogant so-and-so!  Therapy isn’t just letting people state their problem, and then you tell them what to do, ala Ann Landers!  It’s nothing like that!”

But, oh, it is, to a certain extent.  It’s not supposed to be, but it is.

I have worked in quite a few places, mostly hospitals but some outpatient places, and with the rare exception, that’s exactly what the average person will find when he/she goes to a therapist.

Aside #1: Yes, my master’s degree is in experimental psychology, with a minor in special education. But, most of the core requirements are the same as clinical – until you get to the “practicum” part and the graduate level in counseling etc.  

However…when you have access to academic journals and read a lot of research on therapeutic techniques, plus get a lot of continuing education mini-courses/training seminars/conferences through the workplace, you tend to get a lot of clinical knowledge and can use that to drive your therapeutic techniques.  That’s what I did.

Example: The last place I worked at was a methadone clinic.  In my opinion, methadone maintenance is a good idea – in theory.  The theory being, of course, that you switch people from heroin to methadone, then get them off that completely via therapy and tapering.

What a stone pity it doesn’t work that way in practice.

At this particular outpatient facility, the clients had to have failed rehab a lot of times to even get in (not sure why that was a supposedly clinical requirement – but it sure makes for a profitable business).

Some clients came via court order, in lieu of jail.

Some came because they were pregnant (and Pennsylvania, unlike Tennessee and other places, does not automatically charge a woman with child abuse if she becomes pregnant while addicted).  They were worried about their babies.

Some came because they wanted a free alternative to heroin.

Only a few ever came because they wanted, really wanted, to get clean.

The program goes like this: You come in for your dose, and on days when you are required to go to either group or individual therapy, you do that first AND THEN dose.

Let me tell you, there’s nothing like leading group therapy at 5:30 AM with a group of people who are in various stages of withdrawal.  It’s not fair to them, and the fact that usually that was the ONLY way the company could get them into therapy speaks volumes about how ineffective the program is.

And how ineffective the screening process is.

Aside #2: When you admit patients to a program who pretty clearly do not want to deal with their addiction and get off heroin, you can be assured that those patients are going to be quite profitable for your business – because they’ll never get better, and they’ll consistently resist tapering off.  

Cha-ching!  Client for life – or until the insurance runs out.

I sat in on a couple of these “group therapy” sessions when I first started working there.  The first one involved the “therapist” (I cannot and will not call these people therapists, degree or not) playing Hangman with the group.

Hangman!  You know, the game where you guess the word by guessing letters.

Hangman!  Not “Hangman-and-then-we-discuss-these-terms-you-just-guessed-and-apply-them-to-your-addiction”   That might have actually counted as “psychoeducational”.

But just the game?  No, that doesn’t count as anything but “time-filler-for-someone-who-doesn’t-know-how-to-conduct-group-therapy”.  And, “easy-thing-to-do-with-clients-so-they-won’t-hate-me-because-I-won’t-let-them-dose-until-we’re-finished”.

This was typical stuff.  The other things the “therapists” did for group were:

~ Picked a topic and let clients ramble.

~ Brought a Bible and conducted Bible study under the guise of, not in addition to, therapy.  I am all in favor of using the Bible – or any other religious/spirtitual text – if the client’s beliefs are important to them, and if it is an adjunct to therapy.  But in place of therapy?  No, that’s completely unprofessional.

~ Went around the room and asked each client, “So, how are you doing?”  That usually ate up the entire time, and the “therapist” didn’t even have to talk.

Group therapy interventions like showing videos had to be approved by the director (who had no degree in anything, nor had any experience with addiction).  I wanted to show part of a video from PBS explaining where heroin comes from, and how it contributes to terrorism.

My idea was that maybe some clients who couldn’t be reached other ways would possibly be reached by this little nugget of knowledge. Especially if they were Gulf War veterans.

I wasn’t allowed to do it.  Why?  “Showing how heroin is made might trigger them to use.”

Trigger them to use??  When 80-99% of them are testing positive not only for methadone, but for illegal opiates, alcohol, and benzodiazepines?

Aside #3: “Benzodiazepines” are drugs like Xanax and Valium.  If you take them with any kind of opiate or alcohol, you get higher than a kite.  Or stop breathing and die.  Or both.  

This decision of hers just illustrated how little she knows about addiction, therapy, or…well, or about people in general, and addicts in particular, really.

There’s an App for That: Hysteria Over Technology-Fueled STDs?

I am pretty sure some people – who either ought to know better, or should keep their mouths shut – do not understand the difference between “correlation” and “causation”.  And they use this to stir-up hysteria over one thing or another.

This crossed my mind due to 2 articles I read: one was about the DEA’s claim that heroin use is on the rise, and that this is caused by pain medication availability; and the other is an article about Rhode Island’s increase in STDs that are supposedly due to the increase in “hookup” apps like Tinder.

Aside #1: I really don’t understand how my dad could have been the assistant director of the DEA, knowing how opposed he was to the war on drugs.  I guess he thought he could change things from the inside.  He believed that, basically, all drugs should be legal.  And the difference between he and I? He never got fired – a fact that I find astounding even to this day.

So… the first article was called “National Heroin Threat Assessment Summary”It begins by reporting that deaths due to heroin overdoses tripled from 2010 to 2013 – a total of 8,260 people.

I think it’s horrible and devastating when anyone dies, but let’s put this in perspective.  8,260 people out of how many people in the US?   324,892,909 and counting (“Worldometers Population Live Counter”, 5/27/2015 5:57 PM EST).  Although tragic and painfully meaningful to the families and friends of those who passed, this does not indicate an epidemic by any stretch of the imagination.

That’s the first thing that jumped out at me.  I wondered how it was that conservatives freak out over this.  But, let’s read on…

Aside #2: The DEA report PDF file keeps timing out and resetting.  I hope this isn’t a problem for you, too.  But now, as I write this and it has timed out for the 3rd time, I have to go to a secondary source, which I hate to do.  Sorry.

I am switching to a Rhode Island source, which will dovetail nicely into the article on STDs.  Rhode Island seems to have a lot of problems these days!

According the the Providence Journal

“The higher demand for heroin is partly driven by an increase in controlled prescription-drug abuse over the past decade. A recent study by the Substance Abuse and Mental Health Services Administration found that four out of five recent new heroin users had previously abused prescription pain relievers.” (“DEA Report: Heroin Use, Availability is Climbing”, Lynn Arditi, Providence Journal, 5/22/2015).

First of all, SAMHSA is widely used by rehabs, psych hospitals, and other mental health institutions for material on drugs – it’s a federal agency.  They do not have a vested interest in anything but a total ban on drugs, and they make that very clear in the literature they hawk to therapists and others.  They oppose legalization of marijuana and they also want to include “marijuana addiction” as a legitimate addiction for which people need treatment.

Because there is a lot of money in drug rehab facilities, and the more people you can diagnose as “addicts”, the more people you can get into rehab (using not only conventional tactics but also the drug diversion programs).

Anyway, I have a few issues with this “pain medication leads to heroin abuse” idea.  For one thing, the report often referenced by the good ol’ DEA is a self-report…by heroin users.

This is one study that makes such claims, and it is cited on the webpage National Pain Report (a site that purports to be pro-pain patient but isn’t really):

“Cicero and his colleagues analyzed data gathered from more than 150 drug treatment centers across the United States. More than 9,000 patients dependent on narcotic painkillers, or opioids, completed the surveys from 2010 to 2013. Of those, almost 2,800 reported heroin as their primary drug of abuse.” (“Study Finds Most Heroin Users Start with Painkillers”, Pat Anson, National Pain Report, 5/28/2014).

So, addicts who use heroin are saying they started with painkillers?  No, even their own quote which I just cited doesn’t say that.  If anything, it says that of the 9,000 opiate addicts (and it doesn’t say which opiates), 2,800 prefer heroin.

That’s all.  It does not say that heroin users started with painkillers.  Don’t people read??

But yes, I have heard that many, many times as a drug counselor, and I have already written about this in this blog.  The “prescriptions lead to heroin” trope.  And I have seen no real evidence of it, not in the way the anti-drug people mean, anyway.

“I had a back problem and the doctor prescribed narcotics, then cut me off so I had to turn to heroin.”

“A friend gave me pills and I got addicted.”

And so on and so on.  These reports are not reliable, and the reason?  Addicts lie.  A lot.  They will never say, “I love to party and figured I could get high on pills, but they got too expensive so I switched to heroin.”

Or, “I wanted to get high and another addict turned me on to some heroin.”

Many have had no history of pain medication abuse.  Many, particularly here in Central PA, have multi-generational heroin addicts in their families.   They start, and stay with, heroin.

I have only had one client tell me that the reason she used heroin was that it was fun, and she was also the most successful at getting and staying clean.  She was honest, which is the first step an addict needs to take before he/she can stop.

So the DEA trots out that tired old chestnut about painkillers and heroin in order to support its war against pain clinics and pharmacies.  And who are the real victims?

The pain patients.  Because it is getting harder and harder to get pain medication now.

What people fail to understand, besides that addicts lie, is that just because someone used pain meds earlier in life, and now uses heroin, does not mean one caused the other.

They used to say that about marijuana not too long ago, remember?  Heck, they still say that about marijuana here in Central Pa, because there is a heroin problem here and they don’t understand why, or how to treat it.  Their solution is to just toss everyone in jail.  And then let many plead out to go to rehab.  Cha-ching!

The DEA reminds me of a desperate, spurned lover who will do anything to achieve his/her ends.  Even when most critically thinking adults read the DEA report, and conclude that the DEA is grasping at straws, it still doesn’t deter them from proclaiming that prescription pain meds are evil and lead to heroin addiction.

Sudden Falls, Parasols, Walking in Malls: Fitness Challenges for Those Over 50

No ranting today, I think.  This is the fitness program part of my blog.  Because I figure if I write it down, I will be more likely to stick to a program – and can also come back and read my posts for motivation.

My goal is to lose a certain amount of weight by December, 2015.  Since it is May, I think that’s doable.  Not saying how much, but suffice to say I am now a size 16.   I am a lot more comfortable going by dress sizes than weight, because it isn’t so embarrassing to me.

So, by December, the goal is also to get to size 10.

I don’t remember when I was a size 10.  I was a size 8 at age 18, and can you believe I thought I was fat?!  I weighed 120 lbs at 5’4″.  That’s only fat by modeling standards.

Yes, the skinny standard has really not changed much since 1974, sad to say.  Women still think they are fat, pretty much no matter what size they are.

If it isn’t fat, it’s wrinkles/sagging/grey hair/arm flaps (don’t ask if you don’t know, but even Madonna has them, and she works out!).  Women are not really allowed to grow old gracefully.

But I digress…size 10 by December, ok.  That’s really only 3 dress sizes, and I think I can manage that.  If I drop more, my goodness I will be over the moon!

My plan is simple: Walk 30 minutes per day, at least 5 days/week.  And since my Oster “MyBlend” blender arrived today, it’s smoothie time!!

1-2 smoothies per day in place of meals.  I am aware of the calorie trap smoothies can be, so I bought whey powder, 1% organic milk, nonfat yogurt, and frozen fruit.  Protein and carbs.

No green smoothies for me!  Sorry, but I think that green smoothies are the most disgusting-looking drinks on the face of the planet!  I do not like green drinks to slam, I do not like them Sam I Am!

Plus, kale is notorious for having oxalates – and if you get kidney stones, oxalates are a huge no-no.  That includes nuts and nut butters (awww), rhubarb (yuck), potato chips/french fries (awww again), and beets (awww x 3!).

Of course, health websites also say that large amounts of protein can help kidney stones develop.  Damn!  Can’t win!  I’ll take my chances with that one.

What kind of monster would tell someone to give up cheese??  Ain’t happening.  I love love love cheese of all kinds.

So, that’s the plan.  Since I now eat almost nothing but fruit and vegetables – and cheese! – it should be easy.  Oh yeah and the beans and rice thing, too, got to get back to that.  Increasing fiber to a goal of 20-30 grams/day.

If I am still hungry after that (and I’m usually not, fiber is filling!), I tell myself I can eat whatever I want.  Since that is mainly whatever is in my apt, it’s limited.  If I want sugary yummy goodness, I have to either walk to the store, or pick it up once a month when I go food shopping.  That limits it quite a bit.

And even if I just HAVE TO HAVE A DONUT, the donut shop is nearly a mile away so I reckon I would walk off those calories in no time.   The fact that it is so far away, though, deters me from going there (that, and the fact that they replaced the Dunkin’ Donuts with a local, not-as-good donut shop).

The gas station that sells junk food is not far, but they don’t have the kind of junk food I like, so….the local Sheetz, however, does.  It’s half a mile from my apt.  I might actually walk there some time, but since I am so tired most days, it won’t be often.

I have been walking for a week now.  Down to Basin Park, then twice around the trails that go by the Juniata River and the band shell.  It’s a really nice park.  I will show pictures when I actually take good ones (didn’t know Moto had a zoom function, so all the pictures I have taken thus far are teeny tiny).

I have to admit, up until today, I hated my walks.

It wasn’t always that way – any time in the past when I did the walking-for-fitness thing, I enjoyed it for the most part.  But this last go-round, it’s different.

For one thing, I have to get up early so it isn’t hot by the time I get walking.  This is no easy feat, as I have two extremely annoying cats who seem to think it is their life’s purpose to wait about 3 minutes after I have closed my eyes…

Crash! A lamp, a glass, some books?  One cat on the dresser, looking pleased with himself.

I have a floor lamp that has shelves.  One of the cats likes to pull it down.  It’s fun to see all that stuff go flying, I guess.

Or…they could be sleeping on my bed, but a few minutes after I turn off the light to go to sleep myself, one gets up.  Taps me with his paw, on my arm or my face.  The other one finds a box and starts hitting the flap, over and over and OVER again (ok, got to get rid of boxes, I know, but I have no storage space).

So, there’s that issue – getting enough sleep so I can wake up decently at 8 am.  So far, I am dragging my ass outta bed with 4 hours of sleep.  I know it’s just a matter of time before I decide to walk later in the day.  But for now, I am cranky when I get up.

Aside: I can’t kick the cats out of the bedroom and close the door, because I only have one window a/c unit, and that’s in the bedroom.  They would get way too hot – I live upstairs and so it can get mighty hot in my small apt.